Leana Wen: My miscarriage has made my commitment to women’s health even stronger

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By Leana S. Wen

July 6

Leana S. Wen is an emergency physician and the president and chief executive of Planned Parenthood Federation of America.

The turkey sandwich I always had for lunch tasted different. My colleague’s perfume was suddenly overpowering. I could hardly keep awake; when I slept, I had leg cramps and vivid dreams.

I knew before I took the test: I was pregnant.

I was thrilled. My husband and I had been trying for months. We wanted another child, a sibling for our son, Eli, now almost 2. I’m 36; my husband is 44; we didn’t want to wait much longer. Though I worried about how I would do my demanding job with two small children, I also believed that fulfilling my deep desire to expand our family would send a strong message for the organization I represent: We support all people in their decisions when and whether to become parents.

We got more and more excited as we planned for Baby No. 2. If it was a girl, we had a name picked out; if it was a boy, we’d have to go through the baby-name books again. We measured the spare room to turn it into a nursery. We started teaching Eli to be more gentle. I began to plan my maternity leave.

Then, just as suddenly as they’d come on, my nausea, exhaustion and other symptoms went away. I knew even before I went to my doctor that I’d had a pregnancy loss.

When the test results confirmed it, I felt numb. Then I felt the guilt. I knew this was not rational — as many as 1 in 5 pregnancies result in miscarriage, with unsurvivable genetic issues as a major cause of early pregnancy loss. In the emergency room, I’ve counseled many patients who suffered miscarriages. I told myself what I’ve told dozens of women and families, that no one knows what caused the miscarriage, and there’s nothing that could have been done differently. Yet, I couldn’t stop the self-blame: Was it all the travel? Was it the late nights? What if I’d had less stress?

A few days later, I was on a work trip when I started having heavy bleeding and cramping. At the same time I was going through my miscarriage, I was being asked to respond to the breaking story of 27-year-old Marshae Jones facing manslaughter charges (later dropped) for undergoing the same bodily process. Someone shot her in the belly, resulting in her miscarriage, and — incredibly — she was the one accused of a crime. As I spoke, it was hard for me to hold back my tears. How would I have felt if I were Jones— suffering severe bodily harm and mourning the loss of a potential life, while at the same time facing the prospect of imprisonment?

Over the past several months, I’d been on the front lines of the fight against dozens of extreme legislative efforts to ban abortion care. Now, I pictured myself as a woman having a miscarriage in Alabama, Missouri and Georgia. Not only have these states passed bans on abortion early in pregnancy, before many women even know that they’re pregnant, but their new laws also would allow the investigation of women who have had miscarriages to determine whether they, in fact, had an abortion. To be enforceable, any laws that criminalize doctors in this way would require that women be investigated. What cruelty would that be, to compound the trauma of my miscarriage with the indignity of a government investigation into my personal medical records?

Already, in recent years in Tennessee, Wisconsin, Alabama and numerous other states, women have been arrested for endangering their pregnancies by using addictive substances, or falling down the stairs, or taking medications legally prescribed by their doctors. In 2012 in Pennsylvania, Jennifer Whalen brought her 16-year-old daughter to the ER because she was having bleeding and cramping. In the hospital, Whalen admitted that she helped her daughter obtain an abortion by purchasing pills on the Internet. Eventually, she was arrested, convicted and received a jail sentence of nine to 18 months.

If pregnant people are too terrified to seek medical care, they will be forced to make impossible trade-offs, at the cost of their health and lives. I once treated a woman in her late 20s who had a miscarriage complication. If she’d received care early, she could have had a simple outpatient procedure. But by the time she came to the ER, she had such a severe infection that she had to have a hysterectomy and was in the ICU for weeks. My patient suffered serious injury and almost died because she didn’t have health insurance — a situation no one should face — just as no one should have to decide how close to death she needs to be to risk imprisonment for health care.

I was able to return home and visit my regular doctor to receive follow-up care. As I recover over the Fourth of July weekend with my family, I decided to write about my experience because I want to break the silence and shame that often come with pregnancy loss. I also write because my miscarriage has made my commitment to women’s health even stronger. If we truly care about the health of women, children and families, we must commit to policies that provide pregnant women with the care, humanity and dignity that all people deserve.